| Journey 2 Wholeness | |
|
3500 Hadley St Monroe LA 71202-4558 | |
| (318) 341-6029 | |
| Not Available |
| Full Name | Journey 2 Wholeness |
|---|---|
| Speciality | Social Worker |
| Location | 3500 Hadley St, Monroe, Louisiana |
| Authorized Official Name and Position | Mary Lee Green (OWNER/ THERAPIST) |
| Authorized Official Contact | 3183416029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Journey 2 Wholeness 3500 Hadley St Monroe LA 71202-4558 Ph: (318) 341-6029 | Journey 2 Wholeness 3500 Hadley St Monroe LA 71202-4558 Ph: (318) 341-6029 |
| NPI Number | 1063232015 |
|---|---|
| Provider Enumeration Date | 10/15/2024 |
| Last Update Date | 10/15/2024 |
| Certification Date | 10/15/2024 |
| Medicare PECOS PAC ID | 6800326141 |
|---|---|
| Medicare Enrollment ID | O20250215000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063232015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mary Lee Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346856960 PECOS PAC ID: 7618407958 Enrollment ID: I20250215000168 |
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